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ABSTRACTS
A prospective study of 100 pilonidal excisions healing by open granulation is reported. Delays in healing appeared to be due to infection, especially anaerobic bacteria. Comparisons were made among three groups studied consecutively: 30 wounds not treated with antibiotics, 20 given a fixed two-week course of metronidazole, and 50 managed flexibly. In the last group, wound management was determined by clinical appearance: 24 wounds were clinically healthy throughout and received no antibiotic, while 26 looked unhealthy initially or after an interval and were treated with metronidazole, which was supplemented in some cases with erythromycin. The best results were obtained in the group managed flexibly. The problems of delayed healing are considered to be due to excisions that leave a wound poorly shaped to maintain good drainage. Unhealthy wounds should be reshaped if possible, and treated early with a combination of metronidazole and erythromycin.--EUGENE A. GASTON, M.D.
Dis. Col. & Rect. March 1986
McGinn FP, Gartell PC, Clifford PC, Brunton FJ. Staples oi sutures for low colorectal anastomoses: a prospective randomized trial. Br J Surg 1985;72:603. From 1979 - 1984, 118 patients having low colorectal anastomoses were randomly allocated to reconstructions by single layer, interrupted, extramucosal sutures or circular staple gun. The 60 patients undergoing sutured anastomoses had two (3 percent) clinical leaks and four (7 percent) radiologic leaks, and no failures. Among the 58 patients who had stapled anastomoses, there were four failures, seven (12 percent) clinical leaks, 14 (24 percent) radiologic leaks, and one death. Stapled anastomoses were more than ten times more expensive than sutured anastomoses, and there were no savings in time or numbers of associated colostomies. An interrupted, extramucosal suture technique remains the ultimate standard for low colorectal anastomoses.--EUGENE A. GASTON, M.D.
Announcement AMERICAN GASTROENTEROLOGICAL ASSOCIATION POSTGRADUATE COURSE The American Gastroenterological Association will be sponsoring a postgraduate course entitled "The Stomach and Duodenum." The course will be held May 17-18, 1986, at the San Francisco Hilton and Ramada Renaissance Hotels, San Francisco, California. Drs. Charles T. Richardson, Walter L. Peterson, and Mark Feldman are the Directors of the program. T u i t i o n will be $195.00 for AGA members, $220.00 for nonmembers, $90.00 for AGA trainee members, and $95.00 for nonmembers in training. Preregistration is recommended highly, as course enrolhnent will be limited. Contact: Registration Supervisor, SLACK Incorporated, 6900 Grove Road, Thorofare, New Jersey 08086.
